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221 / - iv, ( 5IhO Rd. f)OFFICE USE ONLY PERMIT# f ntr3- 62,-(:) <br /> BUILDING PLANNING <br /> Bldg/TI/Addn/Rem Size R7/0 4 Zoning Classification (" 'v, <br /> Garage Size ` Overlay/Agreement <br /> y [AlV1- I— 011,01 n vt-CaG vl <br /> VALUATION "iJ�0O Nonresidential Use UV� 1 <br /> Number of Stories / Residential Use <br /> Occupancy Group 15 Proposed No. of Dwelling Units: <br /> Occupant Load 3'd Total No. of Dwelling Units: ._--- <br /> Basement No Yes_ Fin / Unfin Landscape or Planning Inspection f <br /> Type of Construction '—" 5 needed before final? Yes_ No 1/ <br /> _ <br /> Existing Sprinkler System? Yes No UnkPlanning Inspector: <br /> Fire Sprinkler Required Yes No_ Phone#: <br /> Reason Approved by Date: /0/ // //7_ <br /> Existing Fire Alarm Yes No—Unk_ Historic Approved by: Date: -- <br /> Fire Alarm Required Yes No_ School Mitigation Reqd? Yes_ No— <br /> ReasonEverett School Dist Mukilteo School Dist <br /> _a <br /> RCW 64.55 MF worksheet req'd for permit? Yes_ No_ #of Net New Units: <br /> Add'I RCW 64.55 docs required prior to final?Yes_ No‘-.2? Calculated School Impact Fee: <br /> Architectural Approved By/Date: .97/C2&7p School Impact Fee Credit: <br /> Structural Approved By/Date: ' I V/i11`- Total School Impact Fee Owed: <br /> Comments: Comments: ----- <br /> Intake OK by: ! 1(D 1(/I* Intake OK by: Ok to route Hold _ <br /> Make this a" 'Permit? Yes— No_ <br /> PUBLIC::WORKS. <br /> FEES INTAKE: Checked By: Date: <br /> Plan Check Fee Comments: <br /> Building Permit <br /> Surcharge High Hazard Sites(Dental/Medical,Animals,Mortuary,etc-Review for RPBA) <br /> Additional Plan Check 0 Public Works/Sys Dev/Traffic Mit./RPBA-NOT REQUIRED <br /> Plumbing Fee 0 Route for Public Works Review(bldg folder, PW Worksheet) <br /> Mechanical Fee 0 Public Works Permit-Concurrent Review(separate green folder) <br /> Ping Bldg Review Fee PW REVIEW: PW Reviewer: ,(S Date: 1C9 "/—/7 <br /> Water Fee 0 PW Permit Approved-PW <br /> Sewer Fee 0 See PW Review Worksheet <br /> Systems Dev. Fee "0 PW Permit Not Required <br /> Traffic Mitigation Fee <br /> Public Works Fee FIRE DEPARTMENT <br /> School Mitigation Fee Update/New Sprinklers Yes k No_ Existing Bldg._ <br /> Update/New Detection .Yes )( No_ Existing Bldg.— <br /> Update/New Chemical Yes_ No_ Existing Bldg. <br /> Update/New Fire Service Yes ,� No_ Existing Bld..— <br /> Approved by: 'co 6, ";Ai— Date: If 3 17 _ <br /> Comments: <br /> 21 <br />